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Diabetes Mellitus Type 2

Clinical Care

Registered Clinical Dietician

During the check-in process at this first visit, Kim May, Registered Clinical Dietitian, asked the height of and weighed each class member and spent some individual time discussing food preferences, the current number and timing of meals/snacks, and other issues surrounding their current diet.

During her part of the first class, Ms. May talked about food and activity. She told the class that carbohydrate foods make blood sugar levels rise. The goal is to control the amount and timing of carbohydrate intake to keep blood sugar levels in the target range. Carbohydrate foods include fruits and fruit juices; starchy foods such as potatoes, beans, rice and pasta; breads; milk and some milk products; and sweets. The class studied a list of common carbohydrate foods to learn how much of each type of food makes up one carbohydrate choice.

Ms. May told the class they should space their meals and snacks no more than 6 hours apart, but to allow at least 2 hours between meals and snacks. Each snack should be one or two carbohydrate choices, and each meal should be three or four carbohydrate choices. The class played a game where they had to count the carbohydrate choices in some sample meals. They also learned that one carbohydrate choice is equal to 15 grams of carbohydrates. Ms. May passed around sample food labels, and each person learned how to read the total carbohydrate grams in a serving of food.

Ms. May emphasized that there were no "forbidden" foods; the goal was spacing and portion control. She told the class that they would discuss other aspects of nutrition at future classes, including protein and fat intake, dining out, and eating 5 -- 6 servings of fruits and vegetables daily. She asked the class to keep food records on three different days and bring them with them to the next class, marking and totaling the carbohydrate choices.

The final part of the class stressed the importance of physical activity. Ms. May explained that physical activity can lower blood sugar levels and helps your body to better use the insulin it produces. It can also increase energy, improve heart health, lower blood pressure, increase strength, endurance and flexibility, and lead to weight loss or maintenance.

She recommended starting slow, such as incorporating a 30-minute walk into daily activities. Each person in class was encouraged to develop a specific goal relative to physical activity, that they would follow for the next two weeks. Alvin said he would try to take a walk after dinner each night. His wife whole-heartedly endorsed the idea, and said she would go with him.

Ms. May gave Alvin his individualized meal plan and spent some time with he and his wife discussing ways to modify some "favorite" foods to fit into his meal plan.